The overall goal of the Academic Rheumatology and Clinical Immunology Training Program at UCSF is to provide advanced training in biomedical research and in health services research to qualified individuals with M.D., M.D./Ph.D., or Ph.D. degrees who plan to pursue careers in academic rheumatology. A major objective of this program is to provide trainees with an environment in which they can: (1) undertake formal didactic course work in a chosen area of concentration; (2) learn how to investigate a scientific problem in depth; master state-of-the-art research techniques; and (4) understand what constitutes good science. In the past, training in our program has taken advantage of the resources of the Rheumatology Divisions of the Department of Medicine at UCSF: one at Moffitt-Long University Hospital, one at San Francisco General Hospital, and one at the San Francisco A Medical Center. These divisions have particular strength in two of the most rapidly developing areas of medical science-biomedical research in immunology and molecular biology, and health service research with an emphasis on outcomes research. These areas of strength are responsive to the unprecedented recent advances in basic science and to the important national changes in health care delivery. In this competitive renewal application, we propose to further strengthen our program in two crucial areas. First, we propose to include research training for postdoctoral fellows in Pediatric Rheumatology. In recent years, UCSF has build one of the top clinical programs in Pediatric Rheumatology in the country, and it will be beneficial to trainees in both adult and pediatric rheumatology. to formally integrate the research programs. Second, we recently initiatived a major new clinical trials program in Rheumatology, focused primarily on the study of novel biologic therapies for rheumatic diseases. This new program, and its faculty, will substantially expand training opportunities for postdoctoral fellows who have a primary interest in clinical research. The Rheumatology and Clinical Immunology program at UCSF provides an outstanding environment of interaction and collaboration among faculty in the Department of Medicine and faculty in the graduate program in Immunology. Furthermore, substantive interactions between scientists in basic research and scientists in clinical research, as well as integrated research experiences for trainees in adult and pediatric rheumatology, create an atmosphere of respect for all aspects of our discipline. The program is intended to support six highly qualified individuals through two or three years of rigorous scientific training, with the objective that they will devote their subsequent careers to the study of the rheumatic and immunologic diseases.